17 ms·

At St. Paul 'wet house,' liquor can be their life - and death

124 points by michaelfairley 16y ago

deleted 16y ago
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deleted 16y ago
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deleted 16y ago
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fendrak 16y ago
I can see the point of a true hospice, where giving up is really the only thing left to do. However, alcoholism has no definable 'point of no return', at least not to my knowledge. Should we really 'give up' on people addicted to a substance, just to save a buck? How much is a human life worth?
deleted 16y ago
[deleted]
Groxx 16y ago
Interesting. I can see how it would be appealing to long-time alcoholics (the "endless optimism" would get pretty sickening). Not entirely sure what my stance is on it, though - it's essentially long-term non-profit euthanasia. It's what they want, but it's also what they want because they're addicted and it's re-wired their brain so drastically they'll do just about anything to keep feeding it. On the flip side, rehabilitating someone who doesn't want to be rehabilitated to some degree is essentially throwing enormous sums of money down the drain, and drags that time of their life far lower than it was before. Instead, this offers them companionship and fewer insults (and keeps them in line) until they die, and that seems to be what many people want - what they have for shorter instead of something else which may or may not be better for longer. If nothing else, it has jogged my thinker; I'll probably debate with myself for a while on this :)
- jackolas 16y ago
  I want to know if someone actually stops drinking being in there. I mean if they viscerally feel death and don't actually wish it...
  - Groxx 16y ago
    That'd be an interesting thing to check out. They do get to see first-hand what it's doing to others around them, over a period of time. It'd be a unique incentive to quit.
  - alexandros 16y ago
    Also, when the constant pressure is taken off and their basic needs are taken care of, maybe some of them can reflect and take a less forced decision to quit. But maybe I'm underestimating alcohol's hold.
  - sophacles 16y ago
    I seem to recall a story about this place, or a similar one, where a couple residents decided to sober up after "living the dream" (free booze for life!) and still not finding happiness. Many more tho drank themselves to death there.
- joe_the_user 16y ago
  Even as something of a liberal, this makes me feel conflicted. It doesn't quite feel like harm reduction - just cost-reduction for the agencies. It's very bleak.
  - Groxx 16y ago
    But if you can't really reduce the harm (or not much), but you can significantly reduce the cost... is bleak bad? America is on a huge "everyone should be happy" kick - smile all the time, buck up and be cheerful, if you're not happy take this pill - but that has its own problems, and masks problems like these people are having, making them worse. It also trivializes pain / unhappiness - everyone can have it! Why don't you? Try this pill, go to a meeting, look everyone can do it! - and given the amount of depression occurring can it even be said to be working? For some, sure - there are outliers in any system of people.. There's also that it can cause things to get even worse - if everyone really can / should be happy, and I can't, clearly something's wrong with me. You'll find a lot of depressed people in that line of thinking, and it crops up in suicides pretty often too. Not really disagreeing, just debating with myself / you / the Internets.
reeses 16y ago
Why precisely is this Hacker News material?
- ekoontz 16y ago
  It's late Saturday night in California? :)
  - reeses 16y ago
    Hah, you had the same idea I did about five minutes after I posted my comment. It's quiet...almost too quiet... :-)
- SamReidHughes 16y ago
  It's interesting.
  - reeses 16y ago
    Why is it interesting? Is it interesting for a reason that would guide one to post it here vs. Reddit or Slashdot, which are both wider ranging in their topics of discussion? You state an opinion as if it were fact.
- ekoontz 16y ago
  Seriously though, I found it interesting and am glad it was on Hacker News. Social engineering is engineering, and engineering is Hacker News. You are minimizing the harm and cost in a society by providing a place where people can safely use alcohol. It's far better and cheaper than leaving them to do it on the streets.
  - vannevar 16y ago
    Speaking as an engineer myself, there is more to life than minimizing costs to society. You could argue that the cheapest path for society is to commit mass suicide, reducing our collective social burden to zero. I do think this is a good article for HN precisely because it highlights the fundamental moral question: what exactly is social engineering supposed to optimize?
originalgeek 16y ago
State sponsored homicide on the installment plan.
- ars 16y ago
  Suicide maybe, but not homicide - they have to get their own alcohol, the center does not provide it.
RevRal 16y ago
My step brother's uncle was an alcoholic for ~25 years (off and on for 25 years? I don't know how this works). He joined the native American church, where he presumably used peyote, and the alcoholism eventually went away and he is now happy. I am by no means read on the subject, just some first hand experience seeing someone crawl out of a pit of despair. It's unfortunate that this avenue isn't researched or condoned much.
- Alex3917 16y ago
  "It's unfortunate that this avenue isn't researched or condoned much." Right now MAPS.org is doing an observational study of Pangaea Biomedics, one of the more famous ibogaine clinics in Mexico. Claire Wilkins (who runs it) gave a pretty amazing talk at Horizons this year, which you can watch here: http://www.youtube.com/watch?v=L0tt3mgT8gA http://www.youtube.com/watch?v=L0tt3mgT8gA
verysimple 16y ago
I don't think I have a problem with it yet, because I'm rationalizing. It somehow makes sense. I'm not sure I would feel the same if someone I cared for decided this would be the solution to their problem though. I suspect many people will feel similarly. If my suspicions are correct, I wonder if we're witnessing a paradigm shift about problems such as alcoholism, drugs and homelessness. Are we as a society beginning to accept that some people are beyond redemption and should just be considered a "loss"? How far can we take this?
- hessenwolf 16y ago
  I have read of a shift from treating addiction as a criminal issue to treating it as a public health issue, and this seems to fit with that. As with cancer, when a cure seems sufficiently improbable, trying to salvage remaining dignity while also reducing costs to society, through hospices, is certainly thought of well around here.
- cosmicray 16y ago
  Try thinking of it like this ... Every life has a beginning, a middle, and an end. Some lives are very short, a few are very long, and most somewhere in the middle of the curve (something the insurance companies call the actuarial). Everyone wants to live as long as possible, but how you get from beginning to end varies widely. What works for me, may not work for you. Trying to impress one social groups idea of 'proper lifestyle' is what causes most of the problems in America (possibly elsewhere) today. There are times, when a little bit of the problem, is a better cure than all the societal enforced behavioral change. For the most part, we really are smart people.
deleted 16y ago
[deleted]
Pahalial 16y ago
The MeFi thread on this a few days ago had some good content, including the abstract from a study on just how drastically housing the homeless and/or alcoholic reduces overall costs to society http://www.metafilter.com/100658/Everyone-is-going-to-keep-drinking-its-probably-going-to-kill-them-and-no-ones-going-to-talk-them-out-of-it http://www.metafilter.com/100658/Everyone-is-going-to-keep-d... I still don't know how I feel about it, though. Just sad rather than strongly for or against.
seertaak 16y ago
It seems pretty logical that St. Anthony's -- in certain cases -- is preferrable to the AA model. What bothers me is that my understanding is that a large percentage of long-time alcoholics and homeless have mental health issues. These issues would perhaps best be addressed by forcably interning them in mental health institutions (which, again according to my limited understanding, have gotten somewhat of an unfairly bad reputation in the last fifty years). Perhaps using the the correct pharmaceuticals and treatment would be better than the "drink yourself to death" approach. However, this would involve removing the freedom of the homeless person to decide for himself. It's a tough choice, but all in all I applaud rational systems that are subject to a-posteriori measurements of efficacy.
AndrewVos 16y ago
"They have peed on their last couch" Hilarious
- smcl 16y ago
  Nope, alcoholism is not hilarious. It's pretty sad.
teyc 16y ago
This is the equivalent of heroin injection galleries that has been trialled in various parts of the world. The basic idea is that these people are at less risk of overdosing, or sharing needles. Basic medical care is readily available should these people need it. I just haven't heard it being done for chronic alcoholics. But the hospice analogy is correct. It is the equivalent of palliative care for cancer patients who have given up (or their doctors have given up) further treatment.
iamelgringo 16y ago
My first job in a hospital (I'm an ER nurse ) in 1993 was as an ER tech at Hennepin County Medical Center in Minneapolis. After welfare checks came out at the beginning of the months, we would have literally dozens of homeless alcoholics lining the hallways of the ER, sometimes stacked in gurneys along the wall, three deep. The beginning of the month, people would drink hard liquor. Middle of the month, cheap grain alcohol and towards the end of the month, when Walgreens sold 1 liter bottles of Listerine for $2, "List" became the drink of choice. At the time, it was illegal to be publicly intoxicated in Minneapolis, so the police would pick up the drunks and bring them to the ER for medical clearance, but never take them to jail when they were sober. So, the drunks would marinate all night in the ER until they could blow less than 0.1 on a breathalyser and then they could walk out. ER overcrowding with drunks became such a huge problem, that the hospital opened up a "drunk tank" or a dedicated hospital unit to let these guys sleep and sober up. It was a 25 bed unit, and you weren't eligible to stay on that unit unless your alcohol level was over 0.3. I routinely saw people at 0.4 and occasionally 0.5. (Legally drunk in California is 0.08 these days.) On top of that, the ER built a dedicated holding unit for the alcoholics who blew between 0.1 and 0.3 on the breathalyser. It was an 8 room locked holding unit. staffed by 2 nurses, 2 security guards and 2 ER techs. One night, I remember holding over 26 patients in there. One night, two police officers (understandably) who were quite fed up with the situation brought in 3 patients soaked in urine and feces in to the ER in their patrol car. They could only fit 1 in the back seat of their car, so they brought the other two.... in the trunk of the cop car. Bad plan. Someone called the press, the cops were suspended. The two alcoholics pressed a lawsuit against the city of Minneapolis, and were awarded $4 Million in damages. Hennepin County Medical Center, the ER where the alcoholics were brought to knew these two men well. They had had over 200 ER visits and/or hospitalizations in the previous 2 years. So, Hennepin County immediately pursued payment for these two men's ER bills (over $2 Million each), and got a lien on the lawsuit money. A month after the suit was settled and these men received the payment for the county, and paid off their hospital bill, they started frequenting the ER where I worked yet again--passed out, covered in feces and soaked in urine. I'm not trying to make judgments. It's a terrible situation all around. Alcoholism is a terrible disease. And, when it's terminal... I think hospice might be the smarter choice. At least via the hospice model, the alcoholics can die with a few shreds of dignity instead of passing out drunk in a snow bank when it's -20F in the Minnesota winters and having toes and then feet amputated because of frost bite. Also, in the hospice model, the health care system can take care of people who can best use their services. Good article. It brought back a lot of interesting memories. :)
6ren 16y ago
I don't like to think anyone is hopeless. That's because to be truly hopeless requires mathematical certainty, which usually isn't possible in the real world. In the real world, we don't know everything; there are always unknowns. Where there are unknowns, there is a chance; there is hope. Giving love and care and respect to these alcoholics... I would expect that that might help some of them to recover. The article doesn't mention it, but I wonder if some do recover. It certainly seems economically justifiable. Which doesn't necessarily make it right, since an economic analysis doesn't take into account all the factors. A society that starts to classify some people as hopeless and give up on them, may gradually widen its definition of hopeless. Whereas some of the greatest benefits and victories for society seem to come from goals that seemed impossible, aka hopeless. If we undermine that, we will be the worse for it.
- Daishiman 16y ago
  If the money saved on treatment for these people can be better spent in improving policy and other aspects in society, then it appears to be money well spent. Transplant patients are prioritized, among other things, on the chance that they will be able to recover from their illnesses. Alcoholics are never given transplants for that reason. At some point you have to take into account what works best statistically, otherwise you are being unfair to those who have not wasted their chances.
patrickgzill 16y ago
I wonder how much of the $18K per resident cost is defrayed by taxes on the liquor they are drinking (though Listerine as mentioned in the article as something some drink, would only have sales tax on it). Note that one of the men has a 20-mile bike route for collecting cans - be interesting to know, despite his alcoholism, what kind of physical shape he is in. Surely he burns off some of the bad effects of drinking via exercise?
- ars 16y ago
  Alcohol is already quite good for the heart and circulatory system. It the liver that is the problem, and exercise won't help there.
vannevar 16y ago
I find the rationalization that this is a cheaper alternative to be morally abhorrent. Why not make it even cheaper and euthanize them at the door?
- vannevar 16y ago
  Wow, someone downvoted that. Could you elaborate on why you think reducing social cost is a valid argument for promoting suicide? Note that I'm not saying there aren't valid arguments supporting the St Paul's approach, I'm only suggesting that "because it's cheaper" is an incredibly callous and cynical one.
  - stjohn 16y ago
    I didn't downvote you, but to answer your question, first, no one is promoting suicide. This system allows people to lead a life you don't consider worthwhile, but they are still living, and the life they are living seems to be objectively better than the one they would be living otherwise. In addition, it's cheaper. So win-win. If it wasn't cheaper, their would still be an argument to be made in favor of wethouses because it seems to be far more humane than allowing people to rot away on the streets. But then the debate would be whether or not society should have to bear the cost of their poor decisions. In fact, they will have a cost to society no matter what. It just so happens that the best thing for them is also the cheapest thing for society, so there is no possible objection. So the argument goes. No one is saying, "Do it because it's cheaper." They're saying, "Don't not do it because it's more expensive, because it isn't -- it's cheaper."
    - vannevar 16y ago
      The tag line of the article reads "It's a place where the most hopeless of alcoholics can drink away their final days at less risk and cost to the public." That sounds like a place where they are invited to come and commit suicide, albeit slowly. I certainly agree that the alternative of turning them out on the streets is less humane. But what about the alternative of committing them to an institution where they have a chance of being cured of their addiction? What about the alternative of a life where they're sober? The article implies that all of these men are incorrigible, but many might simply be people with families who don't have the resources to get treatment, or that simply don't care enough to get it. There is a great danger that because it's cheaper, we'll rationalize away the moral argument in much the same way you do, by pretending that there is no alternative but putting them on the street.
neworbit 16y ago
I'm torn. At what point do we say "these people are not competent to make decisions for themselves, this is just suicide"?

124 points by michaelfairley 16y ago

deleted 16y ago

[deleted]

deleted 16y ago

[deleted]

deleted 16y ago

[deleted]

fendrak 16y ago

I can see the point of a true hospice, where giving up is really the only thing left to do. However, alcoholism has no definable 'point of no return', at least not to my knowledge. Should we really 'give up' on people addicted to a substance, just to save a buck? How much is a human life worth?

deleted 16y ago

[deleted]

Groxx 16y ago

Interesting. I can see how it would be appealing to long-time alcoholics (the "endless optimism" would get pretty sickening). Not entirely sure what my stance is on it, though - it's essentially long-term non-profit euthanasia. It's what they want, but it's also what they want because they're addicted and it's re-wired their brain so drastically they'll do just about anything to keep feeding it. On the flip side, rehabilitating someone who doesn't want to be rehabilitated to some degree is essentially throwing enormous sums of money down the drain, and drags that time of their life far lower than it was before. Instead, this offers them companionship and fewer insults (and keeps them in line) until they die, and that seems to be what many people want - what they have for shorter instead of something else which may or may not be better for longer. If nothing else, it has jogged my thinker; I'll probably debate with myself for a while on this :)

jackolas 16y ago
I want to know if someone actually stops drinking being in there. I mean if they viscerally feel death and don't actually wish it...
- Groxx 16y ago
  That'd be an interesting thing to check out. They do get to see first-hand what it's doing to others around them, over a period of time. It'd be a unique incentive to quit.
- alexandros 16y ago
  Also, when the constant pressure is taken off and their basic needs are taken care of, maybe some of them can reflect and take a less forced decision to quit. But maybe I'm underestimating alcohol's hold.
- sophacles 16y ago
  I seem to recall a story about this place, or a similar one, where a couple residents decided to sober up after "living the dream" (free booze for life!) and still not finding happiness. Many more tho drank themselves to death there.
joe_the_user 16y ago
Even as something of a liberal, this makes me feel conflicted. It doesn't quite feel like harm reduction - just cost-reduction for the agencies. It's very bleak.
- Groxx 16y ago
  But if you can't really reduce the harm (or not much), but you can significantly reduce the cost... is bleak bad? America is on a huge "everyone should be happy" kick - smile all the time, buck up and be cheerful, if you're not happy take this pill - but that has its own problems, and masks problems like these people are having, making them worse. It also trivializes pain / unhappiness - everyone can have it! Why don't you? Try this pill, go to a meeting, look everyone can do it! - and given the amount of depression occurring can it even be said to be working? For some, sure - there are outliers in any system of people.. There's also that it can cause things to get even worse - if everyone really can / should be happy, and I can't, clearly something's wrong with me. You'll find a lot of depressed people in that line of thinking, and it crops up in suicides pretty often too. Not really disagreeing, just debating with myself / you / the Internets.

reeses 16y ago

Why precisely is this Hacker News material?

ekoontz 16y ago
It's late Saturday night in California? :)
- reeses 16y ago
  Hah, you had the same idea I did about five minutes after I posted my comment. It's quiet...almost too quiet... :-)
SamReidHughes 16y ago
It's interesting.
- reeses 16y ago
  Why is it interesting? Is it interesting for a reason that would guide one to post it here vs. Reddit or Slashdot, which are both wider ranging in their topics of discussion? You state an opinion as if it were fact.
ekoontz 16y ago
Seriously though, I found it interesting and am glad it was on Hacker News. Social engineering is engineering, and engineering is Hacker News. You are minimizing the harm and cost in a society by providing a place where people can safely use alcohol. It's far better and cheaper than leaving them to do it on the streets.
- vannevar 16y ago
  Speaking as an engineer myself, there is more to life than minimizing costs to society. You could argue that the cheapest path for society is to commit mass suicide, reducing our collective social burden to zero. I do think this is a good article for HN precisely because it highlights the fundamental moral question: what exactly is social engineering supposed to optimize?

originalgeek 16y ago

State sponsored homicide on the installment plan.

ars 16y ago
Suicide maybe, but not homicide - they have to get their own alcohol, the center does not provide it.

RevRal 16y ago

My step brother's uncle was an alcoholic for ~25 years (off and on for 25 years? I don't know how this works). He joined the native American church, where he presumably used peyote, and the alcoholism eventually went away and he is now happy. I am by no means read on the subject, just some first hand experience seeing someone crawl out of a pit of despair. It's unfortunate that this avenue isn't researched or condoned much.

Alex3917 16y ago
"It's unfortunate that this avenue isn't researched or condoned much." Right now MAPS.org is doing an observational study of Pangaea Biomedics, one of the more famous ibogaine clinics in Mexico. Claire Wilkins (who runs it) gave a pretty amazing talk at Horizons this year, which you can watch here: http://www.youtube.com/watch?v=L0tt3mgT8gA http://www.youtube.com/watch?v=L0tt3mgT8gA

verysimple 16y ago

I don't think I have a problem with it yet, because I'm rationalizing. It somehow makes sense. I'm not sure I would feel the same if someone I cared for decided this would be the solution to their problem though. I suspect many people will feel similarly. If my suspicions are correct, I wonder if we're witnessing a paradigm shift about problems such as alcoholism, drugs and homelessness. Are we as a society beginning to accept that some people are beyond redemption and should just be considered a "loss"? How far can we take this?

hessenwolf 16y ago
I have read of a shift from treating addiction as a criminal issue to treating it as a public health issue, and this seems to fit with that. As with cancer, when a cure seems sufficiently improbable, trying to salvage remaining dignity while also reducing costs to society, through hospices, is certainly thought of well around here.
cosmicray 16y ago
Try thinking of it like this ... Every life has a beginning, a middle, and an end. Some lives are very short, a few are very long, and most somewhere in the middle of the curve (something the insurance companies call the actuarial). Everyone wants to live as long as possible, but how you get from beginning to end varies widely. What works for me, may not work for you. Trying to impress one social groups idea of 'proper lifestyle' is what causes most of the problems in America (possibly elsewhere) today. There are times, when a little bit of the problem, is a better cure than all the societal enforced behavioral change. For the most part, we really are smart people.

deleted 16y ago

[deleted]

Pahalial 16y ago

The MeFi thread on this a few days ago had some good content, including the abstract from a study on just how drastically housing the homeless and/or alcoholic reduces overall costs to society http://www.metafilter.com/100658/Everyone-is-going-to-keep-drinking-its-probably-going-to-kill-them-and-no-ones-going-to-talk-them-out-of-it http://www.metafilter.com/100658/Everyone-is-going-to-keep-d... I still don't know how I feel about it, though. Just sad rather than strongly for or against.

seertaak 16y ago

It seems pretty logical that St. Anthony's -- in certain cases -- is preferrable to the AA model. What bothers me is that my understanding is that a large percentage of long-time alcoholics and homeless have mental health issues. These issues would perhaps best be addressed by forcably interning them in mental health institutions (which, again according to my limited understanding, have gotten somewhat of an unfairly bad reputation in the last fifty years). Perhaps using the the correct pharmaceuticals and treatment would be better than the "drink yourself to death" approach. However, this would involve removing the freedom of the homeless person to decide for himself. It's a tough choice, but all in all I applaud rational systems that are subject to a-posteriori measurements of efficacy.

AndrewVos 16y ago

"They have peed on their last couch" Hilarious

smcl 16y ago
Nope, alcoholism is not hilarious. It's pretty sad.

teyc 16y ago

This is the equivalent of heroin injection galleries that has been trialled in various parts of the world. The basic idea is that these people are at less risk of overdosing, or sharing needles. Basic medical care is readily available should these people need it. I just haven't heard it being done for chronic alcoholics. But the hospice analogy is correct. It is the equivalent of palliative care for cancer patients who have given up (or their doctors have given up) further treatment.

iamelgringo 16y ago

My first job in a hospital (I'm an ER nurse ) in 1993 was as an ER tech at Hennepin County Medical Center in Minneapolis. After welfare checks came out at the beginning of the months, we would have literally dozens of homeless alcoholics lining the hallways of the ER, sometimes stacked in gurneys along the wall, three deep. The beginning of the month, people would drink hard liquor. Middle of the month, cheap grain alcohol and towards the end of the month, when Walgreens sold 1 liter bottles of Listerine for $2, "List" became the drink of choice. At the time, it was illegal to be publicly intoxicated in Minneapolis, so the police would pick up the drunks and bring them to the ER for medical clearance, but never take them to jail when they were sober. So, the drunks would marinate all night in the ER until they could blow less than 0.1 on a breathalyser and then they could walk out. ER overcrowding with drunks became such a huge problem, that the hospital opened up a "drunk tank" or a dedicated hospital unit to let these guys sleep and sober up. It was a 25 bed unit, and you weren't eligible to stay on that unit unless your alcohol level was over 0.3. I routinely saw people at 0.4 and occasionally 0.5. (Legally drunk in California is 0.08 these days.) On top of that, the ER built a dedicated holding unit for the alcoholics who blew between 0.1 and 0.3 on the breathalyser. It was an 8 room locked holding unit. staffed by 2 nurses, 2 security guards and 2 ER techs. One night, I remember holding over 26 patients in there. One night, two police officers (understandably) who were quite fed up with the situation brought in 3 patients soaked in urine and feces in to the ER in their patrol car. They could only fit 1 in the back seat of their car, so they brought the other two.... in the trunk of the cop car. Bad plan. Someone called the press, the cops were suspended. The two alcoholics pressed a lawsuit against the city of Minneapolis, and were awarded $4 Million in damages. Hennepin County Medical Center, the ER where the alcoholics were brought to knew these two men well. They had had over 200 ER visits and/or hospitalizations in the previous 2 years. So, Hennepin County immediately pursued payment for these two men's ER bills (over $2 Million each), and got a lien on the lawsuit money. A month after the suit was settled and these men received the payment for the county, and paid off their hospital bill, they started frequenting the ER where I worked yet again--passed out, covered in feces and soaked in urine. I'm not trying to make judgments. It's a terrible situation all around. Alcoholism is a terrible disease. And, when it's terminal... I think hospice might be the smarter choice. At least via the hospice model, the alcoholics can die with a few shreds of dignity instead of passing out drunk in a snow bank when it's -20F in the Minnesota winters and having toes and then feet amputated because of frost bite. Also, in the hospice model, the health care system can take care of people who can best use their services. Good article. It brought back a lot of interesting memories. :)

6ren 16y ago

I don't like to think anyone is hopeless. That's because to be truly hopeless requires mathematical certainty, which usually isn't possible in the real world. In the real world, we don't know everything; there are always unknowns. Where there are unknowns, there is a chance; there is hope. Giving love and care and respect to these alcoholics... I would expect that that might help some of them to recover. The article doesn't mention it, but I wonder if some do recover. It certainly seems economically justifiable. Which doesn't necessarily make it right, since an economic analysis doesn't take into account all the factors. A society that starts to classify some people as hopeless and give up on them, may gradually widen its definition of hopeless. Whereas some of the greatest benefits and victories for society seem to come from goals that seemed impossible, aka hopeless. If we undermine that, we will be the worse for it.

Daishiman 16y ago
If the money saved on treatment for these people can be better spent in improving policy and other aspects in society, then it appears to be money well spent. Transplant patients are prioritized, among other things, on the chance that they will be able to recover from their illnesses. Alcoholics are never given transplants for that reason. At some point you have to take into account what works best statistically, otherwise you are being unfair to those who have not wasted their chances.

patrickgzill 16y ago

I wonder how much of the $18K per resident cost is defrayed by taxes on the liquor they are drinking (though Listerine as mentioned in the article as something some drink, would only have sales tax on it). Note that one of the men has a 20-mile bike route for collecting cans - be interesting to know, despite his alcoholism, what kind of physical shape he is in. Surely he burns off some of the bad effects of drinking via exercise?

ars 16y ago
Alcohol is already quite good for the heart and circulatory system. It the liver that is the problem, and exercise won't help there.

vannevar 16y ago

I find the rationalization that this is a cheaper alternative to be morally abhorrent. Why not make it even cheaper and euthanize them at the door?

vannevar 16y ago
Wow, someone downvoted that. Could you elaborate on why you think reducing social cost is a valid argument for promoting suicide? Note that I'm not saying there aren't valid arguments supporting the St Paul's approach, I'm only suggesting that "because it's cheaper" is an incredibly callous and cynical one.
- stjohn 16y ago
  I didn't downvote you, but to answer your question, first, no one is promoting suicide. This system allows people to lead a life you don't consider worthwhile, but they are still living, and the life they are living seems to be objectively better than the one they would be living otherwise. In addition, it's cheaper. So win-win. If it wasn't cheaper, their would still be an argument to be made in favor of wethouses because it seems to be far more humane than allowing people to rot away on the streets. But then the debate would be whether or not society should have to bear the cost of their poor decisions. In fact, they will have a cost to society no matter what. It just so happens that the best thing for them is also the cheapest thing for society, so there is no possible objection. So the argument goes. No one is saying, "Do it because it's cheaper." They're saying, "Don't not do it because it's more expensive, because it isn't -- it's cheaper."
  - vannevar 16y ago
    The tag line of the article reads "It's a place where the most hopeless of alcoholics can drink away their final days at less risk and cost to the public." That sounds like a place where they are invited to come and commit suicide, albeit slowly. I certainly agree that the alternative of turning them out on the streets is less humane. But what about the alternative of committing them to an institution where they have a chance of being cured of their addiction? What about the alternative of a life where they're sober? The article implies that all of these men are incorrigible, but many might simply be people with families who don't have the resources to get treatment, or that simply don't care enough to get it. There is a great danger that because it's cheaper, we'll rationalize away the moral argument in much the same way you do, by pretending that there is no alternative but putting them on the street.

neworbit 16y ago

I'm torn. At what point do we say "these people are not competent to make decisions for themselves, this is just suicide"?